Venous intervention

What is Venous Intervention?
Venous intervention describes the minimally invasive technique used to improve or eliminate unsightly or painful varicose veins in the legs. Approximately half of the adult population has some form of vein disease. Contributing factors include heredity, pregnancy, obesity and jobs which require long periods of standing.
There are basically two dominant venous systems draining the legs, the deep and the superficial channels. The veins in the legs are probably the hardest working vessels in the body. They are required to move the blood pumped down to the feet back up to the heart against gravity. To facilitate that movement, these vessels have well developed valves that permit flow in only one direction – back to the heart. The deep system runs within the tough fibrous capsule of the calf muscles. When the calf is flexed, the vein is compressed which aids the movement of the blood back to the heart. This mechanism is referred to as the calf-vein pump complex and is critical to the normal flow of blood out of the legs.
The superficial system runs in the loose connective tissues beneath the skin and, therefore, does not possess the tough, fibrous support found in the deep system. Therefore, if you have a genetic predisposition or other factor that increases the blood volume to the leg veins, the superficial vessels can dilate up making the valves incompetent and causing blood to flow back through the tortuous varicose channels beneath the skin.

Treatment of Varicose Veins and Spider Veins
Spider and varicose veins are often caused by heredity, pregnancy and hormones, and appear on the skin of the legs as raised, discolored webs that can cause pain and swelling for many patients.  These conditions may indicate more serious health problems such as phlebitis, thrombosis or venous stasis ulcers.
There are several minimally invasive procedures available to relieve the painful symptoms and unsightly appearance of spider and varicose veins.

Treatment of Venous Thrombosis
Venous thrombosis involves the formation of a blood clot within the large veins of the leg.  This serious condition can cause permanent damage to the leg by blocking blood flow back to the heart.  Patients with this condition may experience swelling, leg fatigue, leg pain or tenderness and discoloration of the leg.  If left untreated, venous thrombosis can lead to post-thrombotic syndrome or a pulmonary embolism. 
Treating venous thrombosis can often be done through a minimally invasive procedure called catheter-directed thrombolysis, which is performed with imaging guidance and sedation or general anesthesia.  During the procedure, a small incision is made at the site of the blood clot to insert a catheter and feed it into the affected vein.  Special clot-dissolving devices or medication will be administered through the catheter

What is deep vein thrombosis?
Deep vein thrombosis (DVT) is a blood clot (thrombus) in a deep vein, usually in the legs. Clots can form in superficial veins and in deep veins. Blood clots with inflammation in superficial veins (called superficial thrombophlebitis or phlebitis) rarely cause serious problems. But clots in deep veins (deep vein thrombosis) require immediate medical care. See pictures of a developing blood clot  and the leg veins .
These clots are dangerous because they can break loose, travel through the bloodstream to the lungs, and block blood flow in the lungs (pulmonary embolism). A pulmonary embolism is often life-threatening. DVT can also lead to long-lasting problems. DVT may damage the vein and cause the leg to ache, swell, and change color. It can also lead to leg sores after years of having a DVT.
Blood clots most often develop in the calf and thigh veins, and less often in the arm veins or pelvic veins. This topic focuses on blood clots in the deep veins of the legs, but diagnosis and treatment of DVT in other parts of the body are similar.

What causes deep vein clots to form?
Blood clots can form in veins when you are inactive. For example, clots can form if you are paralyzed or bedridden or must sit while on a long flight or car trip. Surgery or an injury can damage your blood vessels and cause a clot to form. Cancer can also cause deep vein thrombosis. Some people have blood that clots too easily, a problem that may run in families. Few reasons for deep vein thrombosis can be listed as below:

  • Slowed blood flow. If you have surgery or are inactive for a period of time (for example, if you are bedridden or must sit while on a long flight or car trip), blood flow in your legs is slowed, which allows a blood clot to form.
  • Damage to the blood vessels. Surgery or injury may damage your blood vessels.
  • Changes in the blood itself.Cancer or certain inherited factors may cause your blood to clot more quickly than normal

What are the symptoms?
Symptoms of DVT include swelling of the affected leg. Also, the leg may feel warm and look redder than the other leg. The calf or thigh may ache or feel tender when you touch or squeeze it or when you stand or move. Pain may get worse and last longer or become constant.If a blood clot is small, it may not cause symptoms. In some cases, pulmonary embolism is the first sign that you have DVT.

How is deep vein thrombosis diagnosed?
If your doctor suspects that you have DVT, you probably will have an ultrasound test to measure the blood flow through your veins and help find any clots that might be blocking the flow. Other tests, such as a venogram, are sometimes used if ultrasound results are unclear. A venogram is an X-ray test that takes pictures of the blood flow through the veins.

How is deep vein thrombosis treated?
Apart from surgery, there are other  treatment  options for DVT. Vena cava filters are used for some people with deep vein thrombosis who have bleeding disorders or other illnesses (including some forms of cancer or a recent bleeding ulcer) and cannot take anticoagulant medicines. This filter can prevent blood clots from traveling to the lungs (pulmonary embolism). But the filter does not stop a clot from forming. Vena cava filters may also be used if you:

  • Continue to develop blood clots even though you have been taking anticoagulant medicines.
  • Have recurrent blood clots and pulmonary hypertension.
  • Cannot take anticoagulant medicine (such as when you have a bleeding disorder, some forms of cancer, or a recent bleeding ulcer).

Compression stockings can also help relieve symptoms of deep vein thrombosis. These stockings can greatly lower your chances of developing postthrombotic syndrome. See a slideshow about how to put on compression stockings.

How to prevent deep vein thrombosis from happening or recurring again?
Check in with your doctor regularly to see if your medication or treatments need to be modified. Watch how much vitamin K you're eating if you take blood thinners. Vitamin K can affect how drugs such as warfarin work. Foods high in vitamin K include green leafy vegetables and canola and soybean oils.
Exercise your lower calf muscles if you'll be sitting a long time. Whenever possible, get up and walk around. If you can't get up to walk around, try raising and lowering your heels while keeping your toes on the floor, then raising your toes while your heels are on the floor.Move. If you've been on bed rest, because of surgery or other factors, the sooner you get moving, the less likely blood clots will develop.
Make lifestyle changes. Lose weight, quit smoking and control your blood pressure. Obesity, smoking and high blood pressure all increase your risk of deep vein thrombosis.

Wear compression stockings to help prevent blood clots in the legs if your doctor recommends them.Be on the lookout for excessive bleeding, which can be a side effect of taking medications such as blood thinners. Talk to your doctor about activities that could cause you to bruise or get cut, as even a minor injury could become serious if you're taking blood thinners.